scholarly journals Indications and types of hysterectomy in the National Referral Hospital of Bhutan, 2020

2021 ◽  
Vol 7 (2) ◽  
pp. 19-23
Author(s):  
Namkha Dorji ◽  
Kencho Zangmo ◽  
Sangay Tshering ◽  
Renuka Mongar ◽  
Sonam Sonam
Keyword(s):  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Skin Incision ◽  
Referral Hospital ◽  
Gynecological Surgery ◽  
Duration Of Surgery ◽  
National Referral Hospital

Introduction: Hysterectomy, the removal of uterus, is a major gynecological surgery performed in Bhutan. It is performed for both benign and malignant gynecological conditions. This study was conducted to assess the socio-demographic profiles, types of hysterectomies and their indications, and duration of surgery and duration of peri-operative hospital stay among women who had hysterectomy at the national referral hospital of Bhutan.  Method: This was a retrospective study conducted at the Jigme Dorji Wangchuck National Referral Hospital, Thimphu. Data of women, who had hysterectomy from 1st January to 31st December, 2020 was extracted into a structured questionnaire by investigators from the patients record maintained at the record section, JDWNRH. Ethical approval was sought from the Research Ethics Board of Health. Data were entered into EpiData 3.1 and was analyzed using descriptive commands of STATA 13.1 Result: Hysterectomy comprised of 9.8% of gynecological surgery in 2020. The commonest route of approach was total abdominal hysterectomy which comprised of 81.7% of hysterectomies. It was found out that 92.9% of hysterectomies were performed under general anesthesia and 97.4% of the surgeries were done as elective or planned cases. The mean (+SD) duration of surgery from skin incision to closure was shortest for vaginal hysterectomy (68.8 + 17.6 minutes) and longest for total laparoscopic hysterectomy (210 + 35.2 minutes). The duration of peri-operative hospital stay was shortest for vaginal hysterectomy. Conclusion: Total abdominal hysterectomy was the common approach despite vaginal hysterectomy being performed under regional anesthesia with shorter duration of surgery and shorter hospital stays.

scholarly journals Comparison of Different Surgical Approaches for Hysterectomy: A Single-Institution Experience

2018 ◽  
pp. 1
Author(s):  
Yusuf Aytac Tohma ◽  
Mehmet Tunc ◽  
Emre Gunakan ◽  
Irem Kucukyildiz ◽  
Latife Atasoy Karakas ◽  
...  
Keyword(s):  
Vaginal Hysterectomy ◽  
Single Port ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Single Institution ◽  
Single Port Access ◽  
Port Access ◽  
Significant Difference ◽  
Duration Of Surgery

<p><strong>Objective:</strong> We aimed to compare surgical outcomes and postoperative complications among different hysterectomy approaches such as total abdominal hysterectomy, vaginal hysterectomy, multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy.</p><p><strong>Study Design:</strong> This retrospective, single institution, case control study was carried out at the Obstetrics and Gynecology Department of Baskent University in Ankara, Turkey. We evaluated 86 consecutive patients who underwent hysterectomy for benign gynecological conditions.</p><p><strong>Results:</strong> A total of 86 women underwent hysterectomy: 20 (23.3%) total abdominal hysterectomy, 20 (23.3%) vaginal hysterectomy, 27 (31.3%) multiport access laparoscopic hysterectomy, and 19 (22.1%) single-port access laparoscopic hysterectomy using a transumbilical single-port system. There was no significant difference in uterine size between groups (Z=5.705; p=0.127). A statistically significant (p&lt;0.001) difference in operation time (duration of surgery) was observed among the following groups. The duration of surgery for the multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy groups was similar, with these two laparoscopic procedures requiring significantly more time than total abdominal hysterectomy and vaginal hysterectomy procedures. There was no statistically significant difference in between hemoglobin levels before and after operation between groups. There was no statistically significant difference between groups in intraoperative and postoperative complications. Six patients experienced complications, one intraoperative and five postoperative. Intraoperative complication was ureter injury in single-port access laparoscopic hysterectomy group. The postoperative complication rate was 5.8% (5 cases) in 86 patients. Perirectal abscess in one patient and wound infection in two patients occurred in total abdominal hysterectomy group (15%). Urinary tract infection in one patient and vaginal cuff cellulitis in one patient occurred in vaginal hysterectomy group (4%). No complications were reported in multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy groups. Post-surgery, all patients who underwent single-port access laparoscopic hysterectomy reported that they were satisfied with their incision and cosmetic results.</p><p><strong>Conclusions:</strong> When technically feasible, multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy may be performed instead f total abdominal hysterectomy because of rapid recovery and shorter hospitalization however there are longer operating time.</p>

scholarly journals Comparison of morbidity associated with non-descent vaginal hysterectomy and total abdominal hysterectomy

2018 ◽  
Vol 7 (4) ◽  
pp. 1554
Author(s):  
Ranjita Ghadei ◽  
Gupteswar Mishra
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Intraoperative Blood Loss ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery ◽  
Stay Time ◽  
Normal Work

Background: In the present scenario of importance non-invasive surgery, there is increase in interest and requirement of vaginal hysterectomy for non-prolapsed uterus, i.e. non-descent vaginal hysterectomy (NDVH) due to its scarless surgery. it has much more advantages than that of abdominal hysterectomy in term of cosmesis, lesser duration of surgery, lesser intraoperative complication, lesser post-operative morbidity and early resumption to work. The aim of the present study is to asses and compare various factors like duration of surgery, intraoperative blood loss, intraoperative and postoperative complication postoperative morbidities, pain perception on 3rd post-operative day, post-operative ambulation, duration of hospital stay, time taken to resume normal work, follow up complains and afterall to decide the appropriate route of hysterectomy for benign conditions.Methods: Hundreds of patients were selected as per the criteria. They were divided into two groups NDVH (non-descent vaginal hysterectomy) and TAH (total abdominal hysterectomy) according to the inclusion criteria. Above mentioned factors are compared between the two groups.Results: Duration of surgery, intraoperative blood loss, intraoperative complications, post-operative morbidities and complications, duration of hospital stay, time required to resume normal work are less in NDVH group.Conclusions: Non-descent vaginal hysterectomy is a better alternative to abdominal hysterectomy for benign conditions.

scholarly journals TLH versus TAH: a 2 year retrospective comparative study

2019 ◽  
Vol 8 (10) ◽  
pp. 3939
Author(s):  
Anju Dogra ◽  
Vinay Kumar ◽  
Nishu Bhushan
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Wound Infection ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Laparoscopic hysterectomy has become a widely accepted technique worldwide, since its introduction by Reich in 1989. The aim of the study was to compare the surgical results and intra- operative and post-operative complications between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH).Methods: Authors conducted a retrospective study at SMGS hospital, GMC Jammu between October 2016 to September 2018, 126 patients who underwent TLH and 126 patients who underwent TAH, were included.Results: Authors observed that there was no significant difference between the two groups in respect to patient’s age, parity and indication of surgery. Duration of surgery was found to be longer in TLH than TAH. The length of hospital stay was less in TLH than TAH. Hb drop was more in TAH group. 25 patients of TAH were given post op blood transfusion but only 9 patients of TLH were given post op blood transfusion. The time to ambulation in patients of TLH was much shorter than TAH. Wound infection was more common in TAH as compared to TLH, 5 patients had wound infection and in 4 patients resuturing was done for wound dehiscence. In 8 patients laparoscopy was converted to laparotomy because of adhesions, vascular injury and in one case because of bowel injury.Conclusions: This study showed that TLH can be safely performed by the experienced surgeon as an alternative to abdominal hysterectomy. It offers several benefits over TAH such as smaller incision, earlier ambulation, shorter hospital stay, faster recovery time and does not increase more serious complications than TAH.

scholarly journals A Comparative evaluation of Non-descent vaginal hysterectomy versus total Abdominal hysterectomy: A hospital based case control study

2019 ◽  
Vol 17 (1) ◽  
pp. 20-22
Author(s):  
Durga BC ◽  
Aseem Sharma ◽  
Binod Mahaseth ◽  
Nirmala Sharma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Benign Pathology ◽  
Operative Complications ◽  
Control Study ◽  
Post Operative Complications

Background: Hysterectomy is a common surgery performed by gynecologist worldwide. It can be done either by vaginal, abdominal or laparoscopic route. Non decent vaginal hysterectomy (NDVH) is less invasive, less time consuming and scar less surgery. The blood loss during surgery, intra-operative and post-operative complications are less in NDVH compare to TAH (total abdominal hysterectomy). Aim and objective: to compare the clinical outcome between NDVH and TAH. Method: A hospital based prospective study was done at Nepalgunj medical collage Kolhapur between March 2018–March 2019, 60 cases fulfilling selection criteria were selected, 30 cases underwent NDVH next 30 cases underwent TAH. Outcome is measured on the basis of operating time, blood loss during surgery, hospital stay and post-operative complications. Result: The most common indication for hysterectomy was fibroid uterus in both the groups (NDVH and TAH). The operating time, blood loss, hospital stay and post-operative complications were less in NDVH as compare to TAH. Conclusion: NDVH is a choice of surgery over TAH for freely mobile uterus with benign pathology and uterus size less than twelve weeks and without adenexal pathology.

scholarly journals A clinical study of elective hysterectomies for benign lesions

2021 ◽  
Vol 10 (6) ◽  
pp. 2414
Author(s):  
Mamta Meena ◽  
Urvashi . ◽  
C. P. Kachawaha ◽  
Dharmendra Singh Fatehpuriya
Keyword(s):  
Clinical Study ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Safe Procedure ◽  
Benign Lesions ◽  
Duration Of Surgery ◽  
The Mean ◽  
Adnexal Pathology ◽  
Histopathological Report

Background: Hysterectomy is widely used for treating a variety of gynecologic conditions. Most hysterectomies are elective and are performed to treat benign indications. Hence the present study was undertaken to determine the benign indication of hysterectomy, choice of surgical approach, safety and clinical aspect of hysterectomy as a surgical procedure and to correlate the findings with histopathological reports of the specimen.Methods: The present series represents a clinical study of 120 cases of elective hysterectomies for benign lesions. Out of which 73 were done by abdominal and 47 by vaginal route. Finally, all operated specimen were subjected to histological examination.Results: The main indications for elective hysterectomy were leiomyoma 53 (44.2%), prolapse 47 (39.2%) and dysfunctional uterine bleeding 11 (9.2%). Type of operation performed were mainly total abdominal hysterectomy with bilateral salphingo-oophorectomy in 60% cases and vaginal hysterectomy with anterior and posterior repair in 38.3% cases. The mean duration of surgery and average blood loss was more in vaginal procedure (90 min and 100ml) compared to abdominal (70 min and 80ml) respectively. Vaginal hysterectomy was associated with less morbidity and a smoother convalescence than abdominal hysterectomy. In 81.2% cases of abdominal hysterectomies correspondence of indication with histopathological report (HPR) were found, in vaginal 74.5% cases corresponded their histopathological report with their symptoms and investigations. Associated adnexal pathology was found in 8.3% cases. There was no mortality during the whole study period.Conclusions: Hysterectomy for benign pelvic lesions is a safe procedure and an important component of health care for women.

scholarly journals Cost-effectiveness of total laparoscopic hysterectomy and non-descent vaginal hysterectomy versus total abdominal hysterectomy: a multi-centre randomized controlled trial

2019 ◽  
Author(s):  
Chanil Deshan Ekanayake ◽  
Arunasalam Pathmeswaran ◽  
Sanjeewa Kularatna ◽  
Rasika Herath ◽  
Prasantha Wijesinghe
Keyword(s):  
Randomized Controlled Trial ◽  
Cost Effectiveness ◽  
Vaginal Hysterectomy ◽  
Controlled Trial ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Randomized Controlled ◽  
Clinical Trials Registry

Abstract Background: Hysterectomy is the most common major surgical procedure in gynaecology. The methods in mainstream practice are; total abdominal hysterectomy (TAH), non-descent vaginal hysterectomy (NDVH) and total laparoscopic hysterectomy (TLH). Most patients requiring hysterectomy for benign gynaecological conditions can be operated using one of these methods. The aim of this study was to study cost-effectiveness of NDVH, TLH and TAH in a low resource setting. Methods: A pragmatic multi-centre three arm (parallel groups) RCT was done in the professorial gynaecology unit of the North Colombo Teaching Hospital, Ragama and the gynaecology unit of the District General Hospital, Mannar, Sri Lanka. Participants were patients requiring hysterectomy for non-malignant uterine causes. Exclusion criteria were uterus>14 weeks, previous pelvic surgery, medical illnesses which contraindicate laparoscopic surgery, and those requiring incontinence surgery or pelvic floor surgery. The main outcome measures were time to recover and cost. The willingness-to-pay (WTP) threshold was set at USD 1000. Results: There was no significant difference in median time to recover (inter quartile range) among TAH, NDVH and TLH which was 35 (30-45), 32 (24.5-60) and 30 (25.5-45) days respectively (p=0.37). The difference in area under the curve for quality adjusted life years (QALYs) was 1.33 and 5.21 for NDVH and TLH compared to TAH. The direct cost (median, interquartile range) of a TLH [USD 349 (322-378)] was significantly higher compared to TAH [USD 289 (264-307)] and NDVH [USD 279 (255-305)]. The incremental cost-effectiveness ratio (ICER) for TLH was USD 12/day whereas NDVH showed a net benefit as both costs and median effect were superior to TAH. The incremental cost utility ratio (ICUR) for TLH and NDVH were 12 and 38 USD/QALY. The ICUR for TLH compared to NDVH was USD 3/per QALY. The net monetary benefit (NMB) was USD 4897 and USD 1264 for TLH and NDVH respectively. Conclusion: Despite there being only a marginal difference among the three routes when considering time to recover, a cost-effectiveness approach using ICER, ICUR and NMB shows that alternate routes, NDVH and TLH to be superior to the conventional TAH. Trial Registration: Sri Lanka clinical trials registry, SLCTR/2016/020 and the International Clinical Trials Registry Platform, U1111-1194-8422, on 26 July 2016. Available from: http://slctr.lk/trials/515. Keywords: Non-descent vaginal hysterectomy, total laparoscopic hysterectomy, total abdominal hysterectomy, cost-effectiveness, randomized controlled trial.

scholarly journals Comparison between Laparoscopic Hysterectomy and Abdominal Hysterectomy

2014 ◽  
Vol 9 (1) ◽  
pp. 26-28
Author(s):  
R Shrestha ◽  
LH Yu
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Short Hospital Stay ◽  
Early Recovery ◽  
Duration Of Hospital Stay ◽  
Operative Recovery

Aims: Hysterectomy can be performed by abdominal, vaginal and laparoscopic methods. Laparoscopic hysterectomy has been reported as an alternative to traditional abdominal hysterectomy with benefit of early recovery, short hospital stay and less operative complications. This study compared laparoscopic versus abdominal hysterectomy in terms of surgery time, blood loss, post-operative recovery, and duration of hospital stay. Methods: This is a retrospective comparative study among sixty patients who underwent laparoscopic or abdominal hysterectomy for various indications in the Department of Obstetrics and Gynaecology of the Third affiliated hospital of Zhengzhou University from January to March 2007. The data of the patients meeting the set criteria were obtained from the hospital records and hospital based computerized coding system. Enrolled cases were divided in two groups with thirty in each arm. Group TLH (total laparoscopic hysterectomy) was designated for patients who underwent total laparoscopic hysterectomy and group TAH (total abdominal hysterectomy) for those who underwent total abdominal hysterectomy. Results: There was comparatively less blood loss in TLH group (60.2±5.17 ml versus 75.7±7.12 ml) but it was statistically insignificant (p=0.12). The laparoscopic hysterectomy took longer time (107.6±32.4 min versus 74.9±31.1 min) than the abdominal (p<0.001). There was early recovery among TLH group 1.6±0.6 days versus 2.1±0.5 days in TAH group (p=0.001). Mean duration of hospital stay was significantly shorter in TLH group 7.6±1.9 days versus 10.1±2.1 days in TAH group (p<0.001). Conclusions: Laparoscopic hyserectomy is an effective alternative to abdominal hysterectomy with the advantage of less intra-operative blood loss, fast recovery and short hospital stay. DOI: http://dx.doi.org/10.3126/njog.v9i1.11183 NJOG 2014 Jan-Jun; 2(1):26-28

Sign in / Sign up

Export Citation Format

Share Document